Two studies released last week by HCIA-Sachs Institute, Evanston, Ill., show that actual pediatric lengths of stay are consistently longer than recommended hospital-stay guidelines for pediatric admissions, even in hospitals deemed to be the most efficient and well-managed. Pediatric length-of-stay guidelines published by Milliman & Robertson were compared with actual stays for pediatric admissions from both the HCIA-Sachs national sample database and its "100 Top Hospitals" database.
Teaching hospitals provide better-quality care to elderly heart-attack patients than nonteaching hospitals, according to a study in the Sept. 12 Journal of the American Medical Association. The nationwide study found that Medicare patients receiving care for myocardial infarction at teaching hospitals were more likely to be alive two years after discharge than those treated at nonteaching hospitals.
New rules designed to increase organ donations by improving communication between hospitals and organ procurement organizations haven't been as effective as hoped, according to a report from HHS' inspector general's office. Acceptance of the new rules, approved in 1998 and implemented last year, is required for hospitals to continue participation in Medicare. In the first year, about 40% of hospitals saw increases in the number of people willing to donate their organs to regional procurement organizations. Despite a projected 10% increase in organ donors in 1999, however, the actual increase in donors was only 1%, to 5,851 in 1999 from 5,807 in 1998.
The Joint Commission on Accreditation of Healthcare Organizations has revised its requirements for use of restraints and seclusion in hospitals. The new rule, effective Sept. 6, requires compliance with HCFA's "one-hour rule" stating that a physician or other practitioner must evaluate patients placed in restraint or seclusion within one hour of the intervention.
Additionally, psychiatric hospitals are doing a better job of following HCFA's new rule on patient restraints, according to a report released earlier this month by HHS' inspector general's office. The report, however, recommended aggressive HCFA monitoring to raise psychiatric hospital compliance, particularly at private facilities.